MEDICARE: COUNSELINGWORKS P A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	4732	FL

General Provider Information

NPI Number	:	1881850337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELINGWORKS P A

Provider Business Mailing Address
First Line	:	6710 EMBASSY BLVD
Second Line	:	SUITE 202
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-7754
Country	:	US
Telephone Number	:	727-967-3320
Fax Number	:	727-848-4795

Provider Business Practice Location Address
First Line	:	6710 EMBASSY BLVD
Second Line	:	SUITE 202
City	:	PORT RICHEY
State	:	FL
Zip	:	34668-7754
Country	:	US
Telephone Number	:	727-967-3320
Fax Number	:	727-848-4795

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. ELIZABETH RUEGG
Credential	:	LCSW
Telephone Number	:	727-967-3320

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	12/16/2008

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